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As a long-time supporter of single payer, it won't surprise you to hear that I believe I've been compromising on health care from day one in Health Care War of 2009. Just to say it one more time: Single payer is the simplest grail--it would be the most cost effective at bringing down out-of-control costs, free at the point of delivery, and never be tied to ability to pay but only to your health needs. Plus: It enhances individual choice and individual health, meets national communitarian values as an American Plan, enables inter-state portability, insures everyone by providing health security for your entire life, frees up doctors to focus on patients and not insurance intermediaries, catalyzes entrepreneurial activity in the health industry both in subsidiary services and in research and development, and is morally just and in sync with our highest political ideas of life, liberty, and the pursuit of happiness.

But, we are talking about the United States Congress, so we move from the best idea to some bright idea.

The easier compromise is with Republicans. The two parties can agree on absolute portability, interstate purchasing from private option insurers, non-termination policies (including for late payments--even the electric company gives you several shut-off notices), and absolute non-discrimination policies, and protection from bankruptcy families in excessive debt because of health care costs. Go this route--the Regulate and Mandate the Private Option route with no additional public options beyond Medicare and Medicaid--and our health care system will not be nationalized but it will be improved for a lot of people, especially those who have insurance now but don't have health care security. Compromise with Republicans in Congress will ensure that the millions of uninsured will have no public option and not much of a private option either. Status quo there. But let's be clear too: If Democrats in Congress have tipped their hand by fighting for the public option, Republicans have tipped their hand too by making it clear that will not compromise on health care reform.

So, it's up to the majority of Democrats. And, compromise among Democrats...now that's a horse of another color. If you can pass reform with a majority and it includes the public option and a liberal health care reform package, do it.

If not, then to all of the above compromises with Republicans, add timelines or triggers for private option insurers to bring the country to universal coverage, say, beginning in 4 years (and while you're at it, deep-six the co-op ideas). Fail to meet the increasing/incremental universal targets, then open a public option by expanding Medicare and allowing people to purchase a plan through Medicare. That's the non-mandate approach on citizens, but it is a mandate for private option insure corporations to leverage their capitalist genius and competitiveness to achieve universal coverage. Also, cap how much employer health benefits can be tax free to subsidize the uninsured (this is somewhat unrelated to the other part, but if we're just making compromises, let's not worry about synchronicity too much). There's more obviously, but these are the value sets.

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